Racial/ethnic inequities in potentially harmful supplement use: Results of a prospective US cohort during the COVID-19 pandemic

Public Health. 2025 Mar:240:104-111. doi: 10.1016/j.puhe.2024.12.054. Epub 2025 Feb 1.

Abstract

Objectives: To quantify racial/ethnic inequities in the use of harmful supplements sold with claims to aid in immune boosting, energy boosting, cleansing/detoxing, and weight loss throughout the first year of the COVID-19 pandemic.

Study design: Prospective cohort study using longitudinal data (April/May 2020-April 2021) drawn from the US-based COVID-19 Substudy (N = 55,098), embedded in the Nurses' Health Studies 2 and 3 and the Growing Up Today Study.

Methods: Modified Poisson models were fit to estimate sociodemographic-adjusted risk ratios (aRRs) and 95 % confidence intervals (CIs) of supplement use by racialized identity. We estimated the contribution of social stressors in driving racial/ethnic inequities in use of immune, energy, cleanse/detox, and weight-loss supplements.

Results: Non-Hispanic Black participants had up to two times higher risk of supplement use compared to Non-Hispanic White participants. Living in a county with a high COVID-19 mortality rate was associated with a slightly elevated risk of immune supplement use, and experiencing chronic high discrimination was associated with an elevated use of all supplement types.

Conclusions: There were stark racial/ethnic inequities in use of harmful supplements throughout the first year of the COVID-19 pandemic.

Keywords: COVID-19; Dietary supplements; Racial inequities.

MeSH terms

  • Adult
  • Black or African American / statistics & numerical data
  • COVID-19 / epidemiology
  • COVID-19 / ethnology
  • Dietary Supplements* / adverse effects
  • Dietary Supplements* / statistics & numerical data
  • Ethnicity* / statistics & numerical data
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • United States / epidemiology
  • White / statistics & numerical data